Doctor Name: | BENJAMIN JOHN BREIDENBACH |
NPI Number: | 1245309327 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 3676012 |
Business Practice Address: | 1640 George St Lacrosse, WI - 54650 |
Business Phone Number: | 6087819880 |
Business Fax Number: | 6087835426 |
Mailing Address: | N5498 Hwy 35, ONALASKA |
State: | WI |
Postal Code: | 54650 |
Phone Number: | 6087795323 |
Fax Number: | 6087795328 |
NPI Enumeration Date: | 11/06/2006 |
NPI Last Update Date: | 09/27/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 3676012 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |